This analysis was prepared by Crossroads Strategies, LLC on behalf of AACOM.

On May 14, 2025, the Senate Committee on Health, Education, Labor, and Pensions held a hearing titled “Hearing on Fiscal Year 2026 Department of Health and Human Services Budget.” 

The hearing focused on proposed reforms and budget cuts at HHS, with Secretary Kennedy defending efforts to streamline the agency, reduce bureaucracy, and prioritize direct health impacts. Lawmakers raised concerns about cuts to research, Medicaid, and public health programs, questioning their effects on vulnerable populations and disease prevention. Kennedy emphasized shifting resources from administration to frontline services, consolidating programs, and lowering drug prices, while maintaining commitments to minority health, addiction, and disease research. Disagreements emerged over the impact of staff reductions, vaccine policy, and funding priorities, with calls for greater transparency, accountability, and bipartisan collaboration to improve health outcomes. A link to the full hearing video may be found: Link.

Witnesses

• The Honorable Robert F. Kennedy Jr. — Secretary of Health and Human Services, Washington, DC

Opening Statements

Chair Bill Cassidy (R-LA):

• President Trump aims to reform the federal government to make health care more affordable and improve American health.
• Bureaucratic bloat and regulatory hurdles at HHS hinder service delivery; reforms are needed to speed up drug approvals and improve health care services.
• This is the first time in two decades the HHS Secretary has testified on the budget before the Health Committee.
• Americans need reassurance that HHS reforms will improve their lives; Secretary Kennedy is here to provide clarity.
• The proposed budget involves consolidating or repurposing offices responsible for key health initiatives.
• Congress and the Administration should collaborate to ensure reforms balance transparency, accountability, and effectiveness.
• Secretary Kennedy is expected to explain how HHS will maintain its duties while implementing necessary changes.

Ranking Member Bernie Sanders (I-VT):

• The U.S. is the sickest developed nation, spending $4.5 trillion annually on health care, which is structurally broken and expensive.
• Health care should be a human right, not a profit-making venture for insurance and drug companies.
• We lack sufficient health care workers, and our life expectancy is shorter despite higher spending.
• Legislative action is needed to lower prescription drug prices, not just executive orders likely to be overturned.
• The Trump administration has cut $13.5 billion in healthcare funding, affecting vital research and vaccine programs.
• Cuts to USAID have resulted in nearly 200,000 deaths globally, contradicting claims that no one has died from these cuts.
• The U.S. should invest in cures for major diseases instead of giving tax breaks to the wealthy.

Secretary Robert F. Kennedy:

• I know President Trump is determined to achieve the lowest drug prices globally, especially compared to Europe.
• He believes Americans shouldn't pay significantly more for drugs like GLP than in places like London.
• I look forward to collaborating on legislation to address this issue.
• The HHS budget for fiscal year 2026 focuses on combating debilitating diseases, contaminated food, toxic environments, addiction, and mental illness.
• Our goals include making America healthy, improving service efficiency for Medicare and Medicaid, and cutting taxpayer costs.
• We must shift funding from bureaucracy to direct impact, preserving programs like Medicare and Medicaid.
• 83 million Americans lack access to primary care; we will prioritize these families, especially Native American and Alaskan communities.
• HHS will consolidate programs to tackle mental health and addiction, combat the opioid crisis, and empower local leaders.
• We will focus on nutrition, physical activity, and healthy lifestyles, with a $94 billion budget request.
• FDA will expand food safety efforts, and NIH will fund cutting-edge research while cutting risky studies.
• We will eliminate DEI funding, redirecting resources to poverty reduction and meaningful action for communities of color.
• Strengthening cybersecurity and health IT is crucial as we manage health data more efficiently.
• We aim to rebuild public trust with transparency and a science-driven HHS, working with Congress to make America healthy again.

Question and Answer

Chair Bill Cassidy (R-LA):

• To what extent will HHS continue to support research and programs for long COVID?
  • Kennedy: I am 100% committed to finding treatments for long COVID. The COVID office was cut by an executive order, but NIH and CDC are committed to these studies.
• How will NIH do more with less funding and build new scientists to compete with geopolitical rivals?
  • Kennedy: We are cutting administrative costs, not working scientists. NIH controls about 70% of global biomedical research funding, and we are ensuring research continues.
• How do you propose balancing returning power to states with replacing necessary public health funding?
  • Kennedy: It's a balance. CDC has a legal obligation for national pandemic response, and we will meet it. Localities often do better with some functions, but CDC will manage national emergencies.

Ranking Member Bernie Sanders (I-VT): 

• What is your goal regarding prescription drug prices, and will you work with us on legislation to achieve it?
  • Kennedy: Yes, I am prepared to work on legislation to achieve lower drug prices, and I believe there is bipartisan support for it.
• Is health care a human right, and will you work to guarantee health care for all Americans?
  • Kennedy: You are asking a philosophical question. Health care is not a constitutional right because it costs money. The goal is to provide Americans with the health care they want.
• Should we guarantee health care as a right like other countries?
  • Kennedy: Americans prefer private insurance. The objective is to find a solution for everyone to have insurance.
• Does the reconciliation bill's cuts to Medicaid and ACA keep America healthy?
  • Kennedy: The cuts are eliminations of waste, not true cuts.
• Does it make sense to give tax breaks to the wealthy while cutting Medicaid?
  • Kennedy: You are conflating congressional bills with presidential proposals. The president is not trying to give tax cuts to billionaires.

Sen. Rand Paul (R-KY): 

• How serious was the breach at Fort Detrick, and is it being investigated?
  • Kennedy: We involved the FBI as it appears to be a deliberate criminal act. The pathogens handled have a high fatality rate, and there are frequent leaks globally from BSL-4 labs. We closed Fort Detrick and ended gain-of-function studies.
• How will you ensure transparency and public scrutiny in gain-of-function research investigations?
  • Kennedy: We will be transparent and have planned a trip to Fort Detrick with experts. We propose a methodology to regulate and determine dangerous gain-of-function research. Intelligence agencies agree NIH research likely led to the COVID pandemic, which we must prevent.

Sen. Patty Murray (D-WA): 

• How many staff have been cut from the NIH's Clinical Center?
  • Kennedy: I can't provide that number now.
• What have you personally done to assess how staff cuts impact patient care?
  • Kennedy: I provided guidelines to ensure clinical trials aren't affected and have met them.
• Natalie Phelps, a mother of two from Bainbridge Island, Washington, has been battling aggressive stage four colorectal cancer for nearly five years. Her best hope now is a clinical trial at the NIH Clinical Center, but due to the mass firing of over 1,100 NIH employees—including critical staff at the Clinical Center—her treatment has been delayed by four weeks, potentially jeopardizing her life. Do you believe cutting NIH by half won't lead to more cases like Natalie's?
  • Kennedy: I don't think the proposed cuts will hurt, but no agency head wants budget cuts.
• How do you explain the NIOSH cuts to my constituents in Spokane?
  • Kennedy: NIOSH work will continue; I've reinstated 328 workers mainly in Cleveland and Morgantown.

Sen. Susan Collins (R-ME): 

• How can you ensure the CDC continues to implement the BOLD Act when staff responsible have been let go?
  • Kennedy: I don't know enough about the program, but divisions have been reassigned under the RE-ORG. I'm committed to Alzheimer's research and want to work with you to ensure programs continue.
• Are you reviewing how NIH's 15% cap on indirect costs affects laboratories?
  • Kennedy: Yes, we are. The cap was to curb abuse by universities with large endowments. I understand state universities weren't abusing it, and we have a plan to address these issues.

Sen. Tammy Baldwin (D-WI): 

• What is your department doing about lead poisoning in children, and why was federal assistance denied to Milwaukee?
  • Kennedy: Lead poisoning is a significant concern. We do not intend to eliminate the CDC branch addressing it.
• Why are Head Start programs in Wisconsin facing funding delays, and what would you say to affected parents?
  • Kennedy: I would be very sad if programs were shut. I fought hard for funding. I will look into the delays; there should not be any. Some delays may be due to internal issues.

Sen. Lisa Murkowski (R-AK): 

• How will the HHS reorganization impact Alaska's vulnerable populations, specifically regarding LIHEAP and NIOSH programs?
  • Kennedy: We should discuss NIOSH further, as it's crucial for commercial fisheries. Regarding LIHEAP, the budget cuts assume energy prices will drop, but if not, Congress should appropriate funds, and I will ensure they are spent.
• What is the status of domestic violence and sexual assault funding, given concerns about delays and potential cuts?
  • Kennedy: My understanding is there were no cuts to domestic violence funding. I will verify, but President Trump is committed to it. Delays might be due to RIFs affecting processing.

Sen. Chris Murphy (D-CT): 

• What is your stance on vaccination funding and your previous statements about vaccines?
  • Kennedy: I need clarification on your question.
• You canceled $12 billion in public health grants, contrary to your statements. You also changed FDA vaccine standards and undermined the measles vaccine. What is your stance on vaccination funding, given your previous statements about vaccines?
  • Kennedy: I disagree with your assertions and will submit evidence for the record.
• Are you recommending measles vaccinations or just presenting pros and cons? Do you understand your statements may reduce vaccination rates?
  • Kennedy: I pledged to tell the truth about vaccines and not claim everything is safe if there are issues. People have lost faith due to being lied to by public officials.
• What is the role of the Secretary of HHS in vaccine recommendations?
  • Kennedy: Vaccine recommendations are made through the Advisory Committee of Immunization Practices at CDC and VRBPAC at FDA. We aim for safety studies before licensure, as vaccines are exempt from pre-licensing safety testing.

Sen. Roger Marshall (R-KS): 

• Can you confirm the increase in HHS employees and the number of divisions and offices?
  • Kennedy: Yes, there are many redundant departments. We aim to consolidate and streamline to reduce administrative costs and improve accountability.
• Do all IT systems within HHS communicate with each other?
  • Kennedy: There are multiple procurement departments with separate systems that don't communicate. We aim to streamline and adopt modern technologies for better healthcare delivery.
• Research on soil health and nutrition is crucial for addressing diseases like cancer and Alzheimer's.
  • Kennedy: NIH has made breakthroughs, but we should focus on identifying causes of diseases like colorectal cancer in children to prevent them, rather than just treating symptoms.

Sen. Tim Kaine (D-VA): 

• What was your involvement in the staff reduction decisions at HHS after your confirmation?
  • Kennedy: I was aware of the decision but not the primary decision maker. My staff made the decision with input from DOGE.
• Were you involved in the decision about the 10,000 RIFs announced on April 1?
  • Kennedy: Yes, I was involved and worked with my leadership team, pushing back on and canceling certain RIFs.
• I confirmed that 20,000 employees have been let go, including 10,000 at HHS.
• I want to know how many of the 20,000 were veterans, as they are disproportionately affected.
• The impact of these layoffs is seen in canceled cancer trials and state grants, like Virginia losing $425 million in health funding.
• CMS is the largest federal agency, and constituents rely heavily on Medicaid, Medicare, and S-CHIP.
• A retiree couldn't get a basic Medicare question answered by CMS, highlighting issues with constituent services.

Sen. Jon Husted (R-OH): 

• Spending more isn't always compassionate; we must consider the national debt burden on children.
• I commend your efforts to create savings and improve service quality without harming health.
• Please share some thoughts on how the budget work will improve health outcomes and generate savings.
  • Kennedy:We certainly have debt issue; it is morally deficient to spend beyond means, as we’ve done historically. I’d like to highlight efforts to revise grass standards and remove synthetic dyes from food. Lengthy dietary guidelines are cumbersome and should be replaced by a concise, locally sourced document. Advocate for removing unhealthy foods from the SNAP program to improve health outcomes.

Chair Bill Cassidy (R-LA):

• I just wanted to clarify that vaccines like rotavirus, measles, and HPV have been evaluated against placebo, contrary to previous statements by the Secretary.

Sen. Maggie Hassan (D-NH): 

• How can parents best protect their children from measles?
  • Kennedy: The best way to stop the spread of measles is through vaccination. We've handled this outbreak better than any other nation.
• Will you fire David Geyer, who has endangered children's health?
  • Kennedy: What you're saying is not true. We did not hire David Geyer to manage autism research at HHS.
• What is David Geyer's job at HHS?
  • Kennedy: David Geyer was hired by an independent contractor to review VSD documents, not as an HHS employee.
• Let the record show he's not a scientist.

Sen. Josh Hawley (R-MO): 

• What is your stance on the new study about mifepristone and its implications for a review?
  • Kennedy: The new data validates previous studies and indicates the need for a label change. I've asked the FDA director for a complete review.
• Do you have a timeline for the review, and will it include considering reinstating safety protocols?
  • Kennedy: I don't have a timeline, but it's a priority. Recommendations will be made based on data, and policy changes will go through the White House.
• Do you still believe in revisiting guidelines around pharmaceutical advertising?
  • Kennedy: Yes, pharmaceutical advertising is problematic as it often hides cheaper generic options and is funded by taxpayer money.
• Should the tax deductibility of pharma advertising costs be changed?
  • Kennedy: Yes, I'm working on this issue and expect a policy soon.
• Can you support legislation to repeal the tax deductibility of these advertisements?
  • Kennedy: I 100% support it.

Sen. John Hickenlooper (D-CO): 

• Do you think our country spends too much on scientific research, and how can we fill the gap in basic research given the cuts?
  • Kennedy: My job is to support the president and OMB. No agency head wants cuts, and I love scientific research. We're aggressively implementing AI and bringing high-quality people from Silicon Valley.
• How can we ensure that fundamental science research, like bench science or epidemiological studies, is adequately funded?
  • Kennedy: We can do a lot of that research quicker. I'll take as much money as you give me and spend it well.
• How can you ensure that firefighters in Colorado can do their jobs safely given the layoffs and cuts?
  • Kennedy: The cuts are painful but necessary due to the President's position on spending. We must protect future prosperity and dignity.
• Can you push back on cuts that save little money but have significant impacts on safety?
  • Kennedy: I'm happy to work with you on that, Senator.

Sen. Jim Banks (R-IN): 

• How will the autism research database handle protected health information, and is it opt-in or opt-out?
  • Kennedy: The database is voluntary, protects patient privacy, and is depersonalized. Patients can opt out, and it helps scientists understand disease treatments.
• Are your critics misrepresenting your views on the causes of autism?
  • Kennedy: Critics are correct that I reject a genetic cause alone; autism is an epidemic needing an environmental toxin alongside genetic vulnerability.
• Have you redirected funding away from genetic autism research?
  • Kennedy: I believe the focus should shift from genetic research to identifying environmental toxins, as genetic research has been overfunded.
• Any updates on reshoring medicine production from China?
  • Kennedy: Exciting developments are happening, partly due to Trump's tariffs. Eli Lilly is aggressively onshoring production, with new facilities that could regain market dominance.

Sen. Ed Markey (D-MA):

• I've heard you defend brutal cuts to Medicaid, NIH research, community health centers, and the CDC for tax cuts for the wealthy.
• Jennifer from my state of Massachusetts is a stage-four cancer patient and depends on uninterrupted NIH funding for research and clinical trials.
• Henry in Rhode Island fears losing his job due to NIH grant cuts, impacting cancer research.
• You've terminated $1.8 billion in NIH funding, which is a blow to hope for patients like Jennifer.
• Lou from Massachusetts lost his son to an overdose and seeks funding for addiction research and treatment.
• Can you justify a billion-dollar cut to substance abuse and mental health programs, including naloxone training for first responders?
  • Kennedy: The budget for my agency increased by 38% under the Biden administration, yet Americans got sicker. More Americans overdosed, died from cancer, and there's an epidemic of colorectal cancers in children. The chronic disease rate is rising to 60%, and the autism rate has dropped to one in 31 children.Despite increased funding, the money did not cure or reverse these diseases.Leadership and a new vision are needed, and I am realigning my agency to address these issues.
• Why would we cut $1 billion from programs for families with substance abuse issues before finding a solution to the opioid problem?
  • Kennedy: Most addiction support programs operate under SAMHSA, and we are maintaining them. President Trump's leadership has reduced fentanyl imports by 40%. We are doing more with less and realigning incentives to improve health and market efficiency.
• 80,000 people died last year; this isn't about efficiency, it's about cruelty.
• Cutting programs for those already addicted and in need is unacceptable.

Sen. Ashley Moody (R-FL):

• While there has been an increase in the agency’s budget, we need to deliberate spending. Responsible spending is crucial for future stability.
• I urge the FDA to tackle the issue of unregulated Chinese illicit vapes affecting children.
  • Kennedy: We are examining the FDA's slow approval process for US vaping companies during the Biden administration. US vaping companies acted responsibly with measures to prevent youth usage and provided addiction information.Due to delays, Chinese companies filled the market with products targeting kids, using attractive designs and flavors. We are committed to eliminating these harmful products.
• How can we lower the sugar content required by regulation to help the domestic orange juice industry?
  • Kennedy: Call Heather Flick or Hannah Anderson this week, and we will act quickly on this.

Sen. Andy Kim (D-NJ): 

• What happened with the staff cuts to the World Trade Center health program, and what can we expect going forward?
  • Kennedy: The cuts were part of overall budget reductions, some of which were mistakes, and I reversed them.
• Were you aware that cutting NIOSH staff would impact the World Trade Center health program?
  • Kennedy: My agency is vast, and we made some mistakes in cuts, but we aim to act decisively for lasting impact.
• Will the World Trade Center Health Program return to its previous strength?
  • Kennedy: The program will continue.
• Why was the National Firefighter Cancer Registry shut down?
  • Kennedy: I am not aware of this issue but will work with you on it.
• Can you promise to work on restoring the National Firefighter Cancer Registry?
  • Kennedy: I will work with you on this issue, Senator.

Sen. Patty Murray (D-WA):

• Secretary Kennedy incorrectly stated that my constituent's care was not delayed by staffing cuts.
• My constituent is already enrolled in the clinical trial; the issue is the delay in care.
• Her NIH doctor confirmed twice that the delay was due to staffing cuts.
• My staff has inquired with HHS leadership, but they have been unresponsive.
• This case is one of many similar situations.

Sen. Scott (R-SC): 

• How will you ensure that programs involving minority health continue and are not unnecessarily tied to DEI?
  • Kennedy: We will continue minority health programs, with seven ongoing. One program tied to DEI was terminated. Thank you for inviting me to South Carolina; it was a model for effective healthcare collaboration.
• Can you reassure parents of children with sickle cell that the administration will work on sickle cell and minority health issues, and will the budget reflect funding for these?
  • Kennedy: Yes, absolutely. I met with a company about a promising new technology for sickle cell. It will remain a priority.
• How will you continue to improve food quality by eliminating artificial food dyes?
  • Kennedy: We are focusing on linking food additives to chronic diseases. NIH and FDA are examining ultra-processed foods and additives to ensure accurate labeling and revoke dangerous authorizations.

Sen. Lisa Blunt Rochester (D-DE): 

• Who is the acting CDC director?
  • Kennedy: The acting CDC director is Dr. Mandy Cohen.
• Does the acting director have a medical or public health background?
  • Kennedy: I believe he is a public health expert.
• Do we have a CDC director, and what are the potential harms until one is confirmed?
  • Kennedy: ACIP does not handle the flu shot.
• Why cut funding for maternal and child health programs, which have proven benefits?
  • Kennedy: You've left me no time to respond. I assure you I will act with compassion.

Sen. Angela Alsobrooks (D-MD): 

• Why have you been unable to answer specific questions about your agency's operations today?
  • Kennedy: I haven't been given time to answer.
• What is your knowledge of the Safe to Sleep campaign and its office location?
  • Kennedy: I believe it's part of HRSA.
• No, it's in the National Institute of Child Health and Human Development.
• Why did you cut funding and staff from the CDC's National Center on Birth Defects and Developmental Disabilities?
  • Kennedy: We moved those programs to the Administration for Healthy America; they haven't been cut.
• Are you aware of the dismantling of the Division of Reproductive Health and Women's Health and Fertility?
  • Kennedy: We are consolidating 42 divisions into fewer ones; it's not a cut.
• What does assisted reproductive technology mean to you, and are you familiar with its division?
  • Kennedy: Are you referring to IVF?
• It's part of your agency, specifically the CDC.